1
|
Alzubaidi L, Al-Dulaimi K, Salhi A, Alammar Z, Fadhel MA, Albahri AS, Alamoodi AH, Albahri OS, Hasan AF, Bai J, Gilliland L, Peng J, Branni M, Shuker T, Cutbush K, Santamaría J, Moreira C, Ouyang C, Duan Y, Manoufali M, Jomaa M, Gupta A, Abbosh A, Gu Y. Comprehensive review of deep learning in orthopaedics: Applications, challenges, trustworthiness, and fusion. Artif Intell Med 2024; 155:102935. [PMID: 39079201 DOI: 10.1016/j.artmed.2024.102935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 03/18/2024] [Accepted: 07/22/2024] [Indexed: 08/24/2024]
Abstract
Deep learning (DL) in orthopaedics has gained significant attention in recent years. Previous studies have shown that DL can be applied to a wide variety of orthopaedic tasks, including fracture detection, bone tumour diagnosis, implant recognition, and evaluation of osteoarthritis severity. The utilisation of DL is expected to increase, owing to its ability to present accurate diagnoses more efficiently than traditional methods in many scenarios. This reduces the time and cost of diagnosis for patients and orthopaedic surgeons. To our knowledge, no exclusive study has comprehensively reviewed all aspects of DL currently used in orthopaedic practice. This review addresses this knowledge gap using articles from Science Direct, Scopus, IEEE Xplore, and Web of Science between 2017 and 2023. The authors begin with the motivation for using DL in orthopaedics, including its ability to enhance diagnosis and treatment planning. The review then covers various applications of DL in orthopaedics, including fracture detection, detection of supraspinatus tears using MRI, osteoarthritis, prediction of types of arthroplasty implants, bone age assessment, and detection of joint-specific soft tissue disease. We also examine the challenges for implementing DL in orthopaedics, including the scarcity of data to train DL and the lack of interpretability, as well as possible solutions to these common pitfalls. Our work highlights the requirements to achieve trustworthiness in the outcomes generated by DL, including the need for accuracy, explainability, and fairness in the DL models. We pay particular attention to fusion techniques as one of the ways to increase trustworthiness, which have also been used to address the common multimodality in orthopaedics. Finally, we have reviewed the approval requirements set forth by the US Food and Drug Administration to enable the use of DL applications. As such, we aim to have this review function as a guide for researchers to develop a reliable DL application for orthopaedic tasks from scratch for use in the market.
Collapse
Affiliation(s)
- Laith Alzubaidi
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia.
| | - Khamael Al-Dulaimi
- Computer Science Department, College of Science, Al-Nahrain University, Baghdad, Baghdad 10011, Iraq; School of Electrical Engineering and Robotics, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Asma Salhi
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - Zaenab Alammar
- School of Computer Science, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Mohammed A Fadhel
- Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - A S Albahri
- Technical College, Imam Ja'afar Al-Sadiq University, Baghdad, Iraq
| | - A H Alamoodi
- Institute of Informatics and Computing in Energy, Universiti Tenaga Nasional, Kajang 43000, Malaysia
| | - O S Albahri
- Australian Technical and Management College, Melbourne, Australia
| | - Amjad F Hasan
- Faculty of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO 65211, USA
| | - Jinshuai Bai
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Luke Gilliland
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - Jing Peng
- Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - Marco Branni
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - Tristan Shuker
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; St Andrew's War Memorial Hospital, Brisbane, QLD 4000, Australia
| | - Kenneth Cutbush
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; St Andrew's War Memorial Hospital, Brisbane, QLD 4000, Australia
| | - Jose Santamaría
- Department of Computer Science, University of Jaén, Jaén 23071, Spain
| | - Catarina Moreira
- Data Science Institute, University of Technology Sydney, Australia
| | - Chun Ouyang
- School of Information Systems, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Ye Duan
- School of Computing, Clemson University, Clemson, 29631, SC, USA
| | - Mohamed Manoufali
- CSIRO, Kensington, WA 6151, Australia; School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD 4067, Australia
| | - Mohammad Jomaa
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; St Andrew's War Memorial Hospital, Brisbane, QLD 4000, Australia
| | - Ashish Gupta
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - Amin Abbosh
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD 4067, Australia
| | - Yuantong Gu
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia
| |
Collapse
|
2
|
Alaimo D, Terranova MC, Palizzolo E, De Angelis M, Avella V, Paviglianiti G, Lo Re G, Matranga D, Salerno S. Performance of two different artificial intelligence (AI) methods for assessing carpal bone age compared to the standard Greulich and Pyle method. LA RADIOLOGIA MEDICA 2024:10.1007/s11547-024-01871-2. [PMID: 39162939 DOI: 10.1007/s11547-024-01871-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 08/01/2024] [Indexed: 08/21/2024]
Abstract
PURPOSE Evaluate the agreement between bone age assessments conducted by two distinct machine learning system and standard Greulich and Pyle method. MATERIALS AND METHODS Carpal radiographs of 225 patients (mean age 8 years and 10 months, SD = 3 years and 1 month) were retrospectively analysed at two separate institutions (October 2018 and May 2022) by both expert radiologists and radiologists in training as well as by two distinct AI software programmes, 16-bit AItm and BoneXpert® in a blinded manner. RESULTS The bone age range estimated by the 16-bit AItm system in our sample varied between 1 year and 1 month and 15 years and 8 months (mean bone age 9 years and 5 months SD = 3 years and 3 months). BoneXpert® estimated bone age ranged between 8 months and 15 years and 7 months (mean bone age 8 years and 11 months SD = 3 years and 3 months). The average bone age estimated by the Greulich and Pyle method was between 11 months and 14 years, 9 months (mean bone age 8 years and 4 months SD = 3 years and 3 months). Radiologists' assessments using the Greulich and Pyle method were significantly correlated (Pearson's r > 0.80, p < 0.001). There was no statistical difference between BoneXpert® and 16-bit AItm (mean difference = - 0.19, 95%CI = (- 0.45; 0.08)), and the agreement between two measurements varies between - 3.45 (95%CI = (- 3.95; - 3.03) and 3.07 (95%CI - 3.03; 3.57). CONCLUSIONS Both AI methods and GP provide correlated results, although the measurements made by AI were closer to each other compared to the GP method.
Collapse
Affiliation(s)
- Davide Alaimo
- Dipartimento di Diagnostica per Immagini Policlinico, Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Maria Chiara Terranova
- UOC Radiologia Pediatrica Dipartimento di Diagnostica per Immagini e Interventistica, ARNAS, Ospedali Civico, Di Cristina Benfratelli, Palermo, Italy
| | - Ettore Palizzolo
- Dipartimento di Diagnostica per Immagini Policlinico, Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Manfredi De Angelis
- Dipartimento di Diagnostica per Immagini Policlinico, Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Vittorio Avella
- Dipartimento di Diagnostica per Immagini Policlinico, Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Giuseppe Paviglianiti
- UOC Radiologia Pediatrica Dipartimento di Diagnostica per Immagini e Interventistica, ARNAS, Ospedali Civico, Di Cristina Benfratelli, Palermo, Italy
| | - Giuseppe Lo Re
- Dipartimento di Diagnostica per Immagini Policlinico, Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Domenica Matranga
- Dipartimento Promozione della Salute, Materno-Infantile (PROMISE), Università Di Palermo, Palermo, Italy
| | - Sergio Salerno
- Dipartimento di Diagnostica per Immagini Policlinico, Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.
| |
Collapse
|
3
|
Zhou HM, Zhou ZL, He YH, Liu TA, Wan L, Wang YH. Forensic bone age assessment of hand and wrist joint MRI images in Chinese han male adolescents based on deep convolutional neural networks. Int J Legal Med 2024:10.1007/s00414-024-03282-4. [PMID: 39060444 DOI: 10.1007/s00414-024-03282-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/23/2024] [Indexed: 07/28/2024]
Abstract
In Chinese criminal law, the ages of 12, 14, 16, and 18 years old play a significant role in the determination of criminal responsibility. In this study, we developed an epiphyseal grading system based on magnetic resonance image (MRI) of the hand and wrist for the Chinese Han population and explored the feasibility of employing deep learning techniques for bone age assessment based on MRI of the hand and wrist. This study selected 282 Chinese Han Chinese males aged 6.0-21.0 years old. In the course of our study, we proposed a novel deep learning model for extracting and enhancing MRI hand and wrist bone features to enhance the prediction of target MRI hand and wrist bone age and achieve precise classification of the target MRI and regression of bone age. The evaluation metric for the classification model including precision, specificity, sensitivity, and accuracy, while the evaluation metrics chosen for the regression model are MAE. The epiphyseal grading was used as a supervised method, which effectively solved the problem of unbalanced sample distribution, and the two experts showed strong consistency in the epiphyseal plate grading process. In the classification results, the accuracy in distinguishing between adults and minors was 91.1%, and the lowest accuracy in the three minor classifications (12, 14, and 16 years of age) was 94.6%, 91.1% and 96.4%, respectively. The MAE of the regression results was 1.24 years. In conclusion, the deep learning model proposed enabled the age assessment of hand and wrist bones based on MRI.
Collapse
Affiliation(s)
- Hui-Ming Zhou
- Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine (21DZ2270800), Shanghai Forensic Service Platform, Key Laboratory of Forensic Science, Ministry of Justice, 1347 GuangFu West Road, Shanghai, 200063, China
- School of Forensic Medicine, Shanxi Medical University, Jinzhong, Shanxi, 030604, China
| | - Zhi-Lu Zhou
- Department of forensic medicine, Guizhou Medical University, Guiyang, 550009, China
| | - Yu-Heng He
- Shanghai Shuzhiwei Information Technology Co., LTD, 333 WenHai Road, Shanghai, 200444, China
| | - Tai-Ang Liu
- Shanghai Shuzhiwei Information Technology Co., LTD, 333 WenHai Road, Shanghai, 200444, China
| | - Lei Wan
- Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine (21DZ2270800), Shanghai Forensic Service Platform, Key Laboratory of Forensic Science, Ministry of Justice, 1347 GuangFu West Road, Shanghai, 200063, China.
- Department of radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China.
| | - Ya-Hui Wang
- Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine (21DZ2270800), Shanghai Forensic Service Platform, Key Laboratory of Forensic Science, Ministry of Justice, 1347 GuangFu West Road, Shanghai, 200063, China.
| |
Collapse
|
4
|
Ciftci R, Secgin Y, Oner Z, Toy S, Oner S. Age Estimation Using Machine Learning Algorithms with Parameters Obtained from X-ray Images of the Calcaneus. Niger J Clin Pract 2024; 27:209-214. [PMID: 38409149 DOI: 10.4103/njcp.njcp_602_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/02/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Determination of bone age is a critical issue for forensics, surgery, and basic sciences. AIM This study aims to estimate age with high accuracy and precision using Machine Learning (ML) algorithms with parameters obtained from calcaneus x-ray images of healthy individuals. METHOD The study was carried out by retrospectively examining the foot X-ray images of 341 people aged 18-65 years. Maximum width of the calcaneus (MW), body width (BW), maximum length (MAXL), minimum length (MINL), facies articularis cuboidea height (FACH), maximum height (MAXH), and tuber calcanei width (TKW) parameters were measured from the images. The measurements were then grouped as 20-45 years of age, 46-64 years of age, 65 and older, and age estimation was made by using these at the input of ML models. RESULTS As a result of the ML input of the measurements obtained, a 0.85 Accuracy (Acc) rate was obtained with the Extra Tree Classifier algorithm. The accuracy rate of other algorithms was found to vary between 0.78 and 0.82. The contribution of parameters to the overall result was evaluated by using the shapley additive explanations (SHAP) analyzer of Random Forest algorithm and the MAXH parameter was found to have the highest contribution in age estimation. CONCLUSIONS As a result of our study, calcaneus bone was found to have high accuracy and precision in age estimations.
Collapse
Affiliation(s)
- R Ciftci
- Department of Anatomy, Faculty of Medicine, Gaziantep Islam Science and Technology University, Gaziantep, Türkiye
| | - Y Secgin
- Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Türkiye
| | - Z Oner
- Department of Anatomy, Faculty of Medicine, İzmir Bakırçay University, İzmir, Türkiye
| | - S Toy
- Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Türkiye
| | - S Oner
- Department of Radiology, Faculty of Medicine, İzmir Bakırçay University, İzmir, Türkiye
| |
Collapse
|
5
|
Tian W, Li D, Lv M, Huang P. Axial Attention Convolutional Neural Network for Brain Tumor Segmentation with Multi-Modality MRI Scans. Brain Sci 2022; 13:brainsci13010012. [PMID: 36671994 PMCID: PMC9856007 DOI: 10.3390/brainsci13010012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/13/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
Accurately identifying tumors from MRI scans is of the utmost importance for clinical diagnostics and when making plans regarding brain tumor treatment. However, manual segmentation is a challenging and time-consuming process in practice and exhibits a high degree of variability between doctors. Therefore, an axial attention brain tumor segmentation network was established in this paper, automatically segmenting tumor subregions from multi-modality MRIs. The axial attention mechanism was employed to capture richer semantic information, which makes it easier for models to provide local-global contextual information by incorporating local and global feature representations while simplifying the computational complexity. The deep supervision mechanism is employed to avoid vanishing gradients and guide the AABTS-Net to generate better feature representations. The hybrid loss is employed in the model to handle the class imbalance of the dataset. Furthermore, we conduct comprehensive experiments on the BraTS 2019 and 2020 datasets. The proposed AABTS-Net shows greater robustness and accuracy, which signifies that the model can be employed in clinical practice and provides a new avenue for medical image segmentation systems.
Collapse
Affiliation(s)
- Weiwei Tian
- Shandong Key Laboratory of Medical Physics and Image Processing, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, School of Physics and Electronics, Shandong Normal University, Jinan 250358, China
| | - Dengwang Li
- Shandong Key Laboratory of Medical Physics and Image Processing, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, School of Physics and Electronics, Shandong Normal University, Jinan 250358, China
- Correspondence:
| | - Mengyu Lv
- School of Environment and Energy, South China University of Technology, Guangzhou 510006, China
| | - Pu Huang
- Shandong Key Laboratory of Medical Physics and Image Processing, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, School of Physics and Electronics, Shandong Normal University, Jinan 250358, China
| |
Collapse
|
6
|
External validation of deep learning-based bone-age software: a preliminary study with real world data. Sci Rep 2022; 12:1232. [PMID: 35075207 PMCID: PMC8786917 DOI: 10.1038/s41598-022-05282-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/10/2022] [Indexed: 11/17/2022] Open
Abstract
Artificial intelligence (AI) is increasingly being used in bone-age (BA) assessment due to its complicated and lengthy nature. We aimed to evaluate the clinical performance of a commercially available deep learning (DL)–based software for BA assessment using a real-world data. From Nov. 2018 to Feb. 2019, 474 children (35 boys, 439 girls, age 4–17 years) were enrolled. We compared the BA estimated by DL software (DL-BA) with that independently estimated by 3 reviewers (R1: Musculoskeletal radiologist, R2: Radiology resident, R3: Pediatric endocrinologist) using the traditional Greulich–Pyle atlas, then to his/her chronological age (CA). A paired t-test, Pearson’s correlation coefficient, Bland–Altman plot, mean absolute error (MAE) and root mean square error (RMSE) were used for the statistical analysis. The intraclass correlation coefficient (ICC) was used for inter-rater variation. There were significant differences between DL-BA and each reviewer’s BA (P < 0.025), but the correlation was good with one another (r = 0.983, P < 0.025). RMSE (MAE) values were 10.09 (7.21), 10.76 (7.88) and 13.06 (10.06) months between DL-BA and R1, R2, R3 BA. Compared with the CA, RMSE (MAE) values were 13.54 (11.06), 15.18 (12.11), 16.19 (12.78) and 19.53 (17.71) months for DL-BA, R1, R2, R3 BA, respectively. Bland–Altman plots revealed the software and reviewers’ tendency to overestimate the BA in general. ICC values between 3 reviewers were 0.97, 0.85 and 0.86, and the overall ICC value was 0.93. The BA estimated by DL-based software showed statistically similar, or even better performance than that of reviewers’ compared to the chronological age in the real world clinic.
Collapse
|
7
|
Kang DS, Lee HJ, Seo YR, Lee CM, Hwang IT. Identifying the role of RUNX2 in bone development through network analysis in girls with central precocious puberty. Mol Cell Toxicol 2021. [DOI: 10.1007/s13273-021-00183-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
8
|
Lee BD, Lee MS. Automated Bone Age Assessment Using Artificial Intelligence: The Future of Bone Age Assessment. Korean J Radiol 2021; 22:792-800. [PMID: 33569930 PMCID: PMC8076828 DOI: 10.3348/kjr.2020.0941] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/17/2020] [Accepted: 10/19/2020] [Indexed: 12/27/2022] Open
Abstract
Bone age assessments are a complicated and lengthy process, which are prone to inter- and intra-observer variabilities. Despite the great demand for fully automated systems, developing an accurate and robust bone age assessment solution has remained challenging. The rapidly evolving deep learning technology has shown promising results in automated bone age assessment. In this review article, we will provide information regarding the history of automated bone age assessments, discuss the current status, and present a literature review, as well as the future directions of artificial intelligence-based bone age assessments.
Collapse
Affiliation(s)
- Byoung Dai Lee
- Division of Computer Science and Engineering, Kyonggi University, Suwon, Korea
| | - Mu Sook Lee
- Department of Radiology, Keimyung University Dongsan Hospital, Daegu, Korea.
| |
Collapse
|
9
|
A deep learning-based computer-aided diagnosis method of X-ray images for bone age assessment. COMPLEX INTELL SYST 2021; 8:1929-1939. [PMID: 34777962 PMCID: PMC8056376 DOI: 10.1007/s40747-021-00376-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/10/2021] [Indexed: 11/18/2022]
Abstract
Bone age assessment using hand-wrist X-ray images is fundamental when diagnosing growth disorders of a child or providing a more patient-specific treatment. However, as clinical procedures are a subjective assessment, the accuracy depends highly on the doctor’s experience. Motivated by this, a deep learning-based computer-aided diagnosis method was proposed for performing bone age assessment. Inspired by clinical approaches and aimed to reduce expensive manual annotations, informative regions localization based on a complete unsupervised learning method was firstly performed and an image-processing pipeline was proposed. Subsequently, an image model with pre-trained weights as a backbone was utilized to enhance the reliability of prediction. The prediction head was implemented by a Multiple Layer Perceptron with one hidden layer. In compliance with clinical studies, gender information was an additional input to the prediction head by embedded into the feature vector calculated from the backbone model. After the experimental comparison study, the best results showed a mean absolute error of 6.2 months on the public RSNA dataset and 5.1 months on the additional dataset using MobileNetV3 as the backbone.
Collapse
|
10
|
Gao Y, Zhu T, Xu X. Bone age assessment based on deep convolution neural network incorporated with segmentation. Int J Comput Assist Radiol Surg 2020; 15:1951-1962. [PMID: 32986142 DOI: 10.1007/s11548-020-02266-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 09/17/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Bone age assessment is not only an important means of assessing maturity of adolescents, but also plays an indispensable role in the fields of orthodontics, kinematics, pediatrics, forensic science, etc. Most studies, however, do not take into account the impact of background noise on the results of the assessment. In order to obtain accurate bone age, this paper presents an automatic assessment method, for bone age based on deep convolutional neural networks. METHOD Our method was divided into two phases. In the image segmentation stage, the segmentation network U-Net was used to acquire the mask image which was then compared with the original image to obtain the hand bone portion after removing the background interference. For the classification phase, in order to further improve the evaluation performance, an attention mechanism was added on the basis of Visual Geometry Group Network (VGGNet). Attention mechanisms can help the model invest more resources in important areas of the hand bone. RESULT The assessment model was tested on the RSNA2017 Pediatric Bone Age dataset. The results show that our adjusted model outperforms the VGGNet. The mean absolute error can reach 9.997 months, which outperforms other common methods for bone age assessment. CONCLUSION We explored the establishment of an automated bone age assessment method based on deep learning. This method can efficiently eliminate the influence of background interference on bone age evaluation, improve the accuracy of bone age evaluation, provide important reference value for bone age determination, and can aid in the prevention of adolescent growth and development diseases.
Collapse
Affiliation(s)
- Yunyuan Gao
- Intelligent Control and Robotics Institute, College of Automation, Hangzhou Dianzi University, Hangzhou, China. .,Key Laboratory of Brain Machine Collaborative Intelligence of Zhejiang Province, Hangzhou, China.
| | - Tao Zhu
- Intelligent Control and Robotics Institute, College of Automation, Hangzhou Dianzi University, Hangzhou, China
| | - Xiaohua Xu
- Kennesaw State University, Marietta, GA, 30060, USA
| |
Collapse
|
11
|
Dallora AL, Kvist O, Berglund JS, Ruiz SD, Boldt M, Flodmark CE, Anderberg P. Chronological Age Assessment in Young Individuals Using Bone Age Assessment Staging and Nonradiological Aspects: Machine Learning Multifactorial Approach. JMIR Med Inform 2020; 8:e18846. [PMID: 32955457 PMCID: PMC7536601 DOI: 10.2196/18846] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/06/2020] [Accepted: 08/13/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Bone age assessment (BAA) is used in numerous pediatric clinical settings as well as in legal settings when entities need an estimate of chronological age (CA) when valid documents are lacking. The latter case presents itself as critical as the law is harsher for adults and granted rights along with imputability changes drastically if the individual is a minor. Traditional BAA methods have drawbacks such as exposure of minors to radiation, they do not consider factors that might affect the bone age, and they mostly focus on a single region. Given the critical scenarios in which BAA can affect the lives of young individuals, it is important to focus on the drawbacks of the traditional methods and investigate the potential of estimating CA through BAA. OBJECTIVE This study aims to investigate CA estimation through BAA in young individuals aged 14-21 years with machine learning methods, addressing the drawbacks of research using magnetic resonance imaging (MRI), assessment of multiple regions of interest, and other factors that may affect the bone age. METHODS MRI examinations of the radius, distal tibia, proximal tibia, distal femur, and calcaneus were performed on 465 men and 473 women (aged 14-21 years). Measures of weight and height were taken from the subjects, and a questionnaire was given for additional information (self-assessed Tanner Scale, physical activity level, parents' origin, and type of residence during upbringing). Two pediatric radiologists independently assessed the MRI images to evaluate their stage of bone development (blinded to age, gender, and each other). All the gathered information was used in training machine learning models for CA estimation and minor versus adult classification (threshold of 18 years). Different machine learning methods were investigated. RESULTS The minor versus adult classification produced accuracies of 0.90 and 0.84 for male and female subjects, respectively, with high recalls for the classification of minors. The CA estimation for the 8 age groups (aged 14-21 years) achieved mean absolute errors of 0.95 years and 1.24 years for male and female subjects, respectively. However, for the latter, a lower error occurred only for the ages of 14 and 15 years. CONCLUSIONS This study investigates CA estimation through BAA using machine learning methods in 2 ways: minor versus adult classification and CA estimation in 8 age groups (aged 14-21 years), while addressing the drawbacks in the research on BAA. The first achieved good results; however, for the second case, the BAA was not precise enough for the classification.
Collapse
Affiliation(s)
- Ana Luiza Dallora
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Ola Kvist
- Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Sandra Diaz Ruiz
- Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Martin Boldt
- Department of Computer Science, Blekinge Institute of Technology, Karlskrona, Sweden
| | | | - Peter Anderberg
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| |
Collapse
|
12
|
Angelakopoulos N, Galić I, De Luca S, Campobasso C, Martino F, De Micco F, Coccia E, Cameriere R. Skeletal age assessment by measuring planar projections of carpals and distal epiphyses of ulna and radius bones in a sample of South African subadults. AUST J FORENSIC SCI 2020. [DOI: 10.1080/00450618.2020.1766111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- N. Angelakopoulos
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - I. Galić
- Department of Research in Biomedicine and Health, School of Medicine, University of Split, Split, Croatia
| | - S. De Luca
- Área de Identificación Forense, Unidad de Derechos Humanos, Servicio Médico Legal, Santiago de Chile, Chile
- AgEstimation Project, University of Macerata, Macerata, Italy
| | - C.P. Campobasso
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - F. Martino
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - F. De Micco
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy
| | - E. Coccia
- Department of Odontostomatology and Specialized Clinical Sciences (DISCO), Polytechnic University of Marche, Ancona, Italy
| | - R. Cameriere
- AgEstimation Project, University of Macerata, Macerata, Italy
| |
Collapse
|
13
|
|
14
|
Dallora AL, Berglund JS, Brogren M, Kvist O, Diaz Ruiz S, Dübbel A, Anderberg P. Age Assessment of Youth and Young Adults Using Magnetic Resonance Imaging of the Knee: A Deep Learning Approach. JMIR Med Inform 2019; 7:e16291. [PMID: 31804183 PMCID: PMC6923761 DOI: 10.2196/16291] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/31/2019] [Accepted: 11/13/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Bone age assessment (BAA) is an important tool for diagnosis and in determining the time of treatment in a number of pediatric clinical scenarios, as well as in legal settings where it is used to estimate the chronological age of an individual where valid documents are lacking. Traditional methods for BAA suffer from drawbacks, such as exposing juveniles to radiation, intra- and interrater variability, and the time spent on the assessment. The employment of automated methods such as deep learning and the use of magnetic resonance imaging (MRI) can address these drawbacks and improve the assessment of age. OBJECTIVE The aim of this paper is to propose an automated approach for age assessment of youth and young adults in the age range when the length growth ceases and growth zones are closed (14-21 years of age) by employing deep learning using MRI of the knee. METHODS This study carried out MRI examinations of the knee of 402 volunteer subjects-221 males (55.0%) and 181 (45.0%) females-aged 14-21 years. The method comprised two convolutional neural network (CNN) models: the first one selected the most informative images of an MRI sequence, concerning age-assessment purposes; these were then used in the second module, which was responsible for the age estimation. Different CNN architectures were tested, both training from scratch and employing transfer learning. RESULTS The CNN architecture that provided the best results was GoogLeNet pretrained on the ImageNet database. The proposed method was able to assess the age of male subjects in the range of 14-20.5 years, with a mean absolute error (MAE) of 0.793 years, and of female subjects in the range of 14-19.5 years, with an MAE of 0.988 years. Regarding the classification of minors-with the threshold of 18 years of age-an accuracy of 98.1% for male subjects and 95.0% for female subjects was achieved. CONCLUSIONS The proposed method was able to assess the age of youth and young adults from 14 to 20.5 years of age for male subjects and 14 to 19.5 years of age for female subjects in a fully automated manner, without the use of ionizing radiation, addressing the drawbacks of traditional methods.
Collapse
Affiliation(s)
- Ana Luiza Dallora
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | | | | | - Ola Kvist
- Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Diaz Ruiz
- Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Peter Anderberg
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| |
Collapse
|
15
|
|
16
|
Artioli TO, Alvares MA, Carvalho Macedo VS, Silva TS, Avritchir R, Kochi C, Longui CA. Bone age determination in eutrophic, overweight and obese Brazilian children and adolescents: a comparison between computerized BoneXpert and Greulich-Pyle methods. Pediatr Radiol 2019; 49:1185-1191. [PMID: 31152212 DOI: 10.1007/s00247-019-04435-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/29/2019] [Accepted: 05/16/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Bone age determination is usually employed to evaluate growth disorders and their treatment. The Greulich-Pyle method is the simplest and most frequently used type of evaluation, but it presents huge interobserver variability. The BoneXpert is a computer-automated method developed to avoid significant bone age variability among distinct observers. OBJECTIVE To compare the BoneXpert and Greulich-Pyle methods of bone age determination in eutrophic children and adolescents, as well as in overweight and obese pediatric patients. MATERIALS AND METHODS The sample comprised 515 participants, 253 boys (159 eutrophic, 53 overweight and 41 obese) and 262 girls (146 eutrophic, 76 overweight and 40 obese). Left hand and wrist radiographs were acquired for bone age determination using both methods. RESULTS There was a positive correlation between chronological age and Greulich-Pyle, chronological age and BoneXpert, and Greulich-Pyle and BoneXpert. There was a significant increase (P<0.05) in bone age in both the Greulich-Pyle and BoneXpert methods in obese boys when compared to eutrophic or overweight boys of the same age. In girls, there was an increase in bone age in both obese and overweight individuals when compared to eutrophic girls (P<0.05). The Greulich-Pyle bone age was advanced in comparison to that of BoneXpert in all groups, except in obese boys, in which bone age was similarly advanced in both methods. CONCLUSION The BoneXpert computer-automated bone age determination method showed a significant positive correlation with chronological age and Greulich-Pyle. Furthermore, the impact of being overweight or obese on bone age could be identified by both methods.
Collapse
Affiliation(s)
- Thiago O Artioli
- Pediatric Endocrinology Unit, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Matheus A Alvares
- Pediatric Endocrinology Unit, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Vanessa S Carvalho Macedo
- Pediatric Endocrinology Unit, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Tatiane S Silva
- Molecular Medicine Laboratory, Santa Casa de São Paulo School of Medical Sciences, 112 Dr. Cesário Mota Jr. St., São Paulo, CEP 01221-020, Brazil
| | - Roberto Avritchir
- Department of Radiology, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Cristiane Kochi
- Pediatric Endocrinology Unit, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
- Molecular Medicine Laboratory, Santa Casa de São Paulo School of Medical Sciences, 112 Dr. Cesário Mota Jr. St., São Paulo, CEP 01221-020, Brazil
| | - Carlos A Longui
- Pediatric Endocrinology Unit, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
- Molecular Medicine Laboratory, Santa Casa de São Paulo School of Medical Sciences, 112 Dr. Cesário Mota Jr. St., São Paulo, CEP 01221-020, Brazil.
| |
Collapse
|
17
|
Dallora AL, Anderberg P, Kvist O, Mendes E, Diaz Ruiz S, Sanmartin Berglund J. Bone age assessment with various machine learning techniques: A systematic literature review and meta-analysis. PLoS One 2019; 14:e0220242. [PMID: 31344143 PMCID: PMC6657881 DOI: 10.1371/journal.pone.0220242] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/11/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The assessment of bone age and skeletal maturity and its comparison to chronological age is an important task in the medical environment for the diagnosis of pediatric endocrinology, orthodontics and orthopedic disorders, and legal environment in what concerns if an individual is a minor or not when there is a lack of documents. Being a time-consuming activity that can be prone to inter- and intra-rater variability, the use of methods which can automate it, like Machine Learning techniques, is of value. OBJECTIVE The goal of this paper is to present the state of the art evidence, trends and gaps in the research related to bone age assessment studies that make use of Machine Learning techniques. METHOD A systematic literature review was carried out, starting with the writing of the protocol, followed by searches on three databases: Pubmed, Scopus and Web of Science to identify the relevant evidence related to bone age assessment using Machine Learning techniques. One round of backward snowballing was performed to find additional studies. A quality assessment was performed on the selected studies to check for bias and low quality studies, which were removed. Data was extracted from the included studies to build summary tables. Lastly, a meta-analysis was performed on the performances of the selected studies. RESULTS 26 studies constituted the final set of included studies. Most of them proposed automatic systems for bone age assessment and investigated methods for bone age assessment based on hand and wrist radiographs. The samples used in the studies were mostly comprehensive or bordered the age of 18, and the data origin was in most of cases from United States and West Europe. Few studies explored ethnic differences. CONCLUSIONS There is a clear focus of the research on bone age assessment methods based on radiographs whilst other types of medical imaging without radiation exposure (e.g. magnetic resonance imaging) are not much explored in the literature. Also, socioeconomic and other aspects that could influence in bone age were not addressed in the literature. Finally, studies that make use of more than one region of interest for bone age assessment are scarce.
Collapse
Affiliation(s)
- Ana Luiza Dallora
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Peter Anderberg
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Ola Kvist
- Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Emilia Mendes
- Department of Computer Science, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Sandra Diaz Ruiz
- Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden
| | | |
Collapse
|
18
|
Qin P, Zhang J, Zeng J, Liu H, Cui Y. A framework combining DNN and level-set method to segment brain tumor in multi-modalities MR image. Soft comput 2019. [DOI: 10.1007/s00500-019-03778-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
19
|
Koitka S, Demircioglu A, Kim MS, Friedrich CM, Nensa F. Ossification area localization in pediatric hand radiographs using deep neural networks for object detection. PLoS One 2018; 13:e0207496. [PMID: 30444906 PMCID: PMC6239319 DOI: 10.1371/journal.pone.0207496] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/17/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Detection of ossification areas of hand bones in X-ray images is an important task, e.g. as a preprocessing step in automated bone age estimation. Deep neural networks have emerged recently as de facto standard detection methods, but their drawback is the need of large annotated datasets. Finetuning pre-trained networks is a viable alternative, but it is not clear a priori if training with small annotated datasets will be successful, as it depends on the problem at hand. In this paper, we show that pre-trained networks can be utilized to produce an effective detector of ossification areas in pediatric X-ray images of hands. METHODS AND FINDINGS A publicly available Faster R-CNN network, pre-trained on the COCO dataset, was utilized and finetuned with 240 manually annotated radiographs from the RSNA Pediatric Bone Age Challenge, which comprises over 14.000 pediatric radiographs. The validation is done on another 89 radiographs from the dataset and the performance is measured by Intersection-over-Union (IoU). To understand the effect of the data size on the pre-trained network, subsampling was applied to the training data and the training was repeated. Additionally, the network was trained from scratch without any pre-trained weights. Finally, to understand whether the trained model could be useful, we compared the inference of the network to an annotation of an expert radiologist. The finetuned network was able to achieve an average precision (mAP@0.5IoU) of 92.92 ± 1.93. Apart from the wrist region, all ossification areas were able to benefit from more data. In contrast, the network trained from scratch was not able to produce any correct results. When compared to the annotations of the expert radiologist, the network was able to localize the regions quite well, as the F1-Score was on average 91.85 ± 1.06. CONCLUSIONS By finetuning a pre-trained deep neural network, with 240 annotated radiographs, we were able to successfully detect ossification areas in prediatric hand radiographs.
Collapse
Affiliation(s)
- Sven Koitka
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- Department of Computer Science, University of Applied Sciences and Arts Dortmund, Dortmund, Germany
- Department of Computer Science, TU Dortmund University, Dortmund, Germany
- * E-mail:
| | - Aydin Demircioglu
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Moon S. Kim
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Christoph M. Friedrich
- Department of Computer Science, University of Applied Sciences and Arts Dortmund, Dortmund, Germany
- Institute for Medical Informatics, Biometry, and Epidemiology (IMIBE), University Hospital Essen, Essen, Germany
| | - Felix Nensa
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| |
Collapse
|
20
|
Forensic age estimation for pelvic X-ray images using deep learning. Eur Radiol 2018; 29:2322-2329. [PMID: 30402703 DOI: 10.1007/s00330-018-5791-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 09/06/2018] [Accepted: 09/21/2018] [Indexed: 02/05/2023]
Abstract
PURPOSE To develop a deep learning bone age assessment model based on pelvic radiographs for forensic age estimation and compare its performance to that of the existing cubic regression model. MATERIALS AND METHOD A retrospective collection data of 1875 clinical pelvic radiographs between 10 and 25 years of age was obtained to develop the model. Model performance was assessed by comparing the testing results to estimated ages calculated directly using the existing cubic regression model based on ossification staging methods. The mean absolute error (MAE) and root-mean-squared error (RMSE) between the estimated ages and chronological age were calculated for both models. RESULTS For all test samples (between 10 and 25 years old), the mean MAE and RMSE between the automatic estimates using the proposed deep learning model and the reference standard were 0.94 and 1.30 years, respectively. For the test samples comparable to those of the existing cubic regression model (between 14 and 22 years old), the mean MAE and RMSE for the deep learning model were 0.89 and 1.21 years, respectively. For the existing cubic regression model, the mean MAE and RMSE were 1.05 and 1.61 years, respectively. CONCLUSION The deep learning convolutional neural network model achieves performance on par with the existing cubic regression model, demonstrating predictive ability capable of automated skeletal bone assessment based on pelvic radiographic images. KEY POINTS • The pelvis has considerable value in determining the bone age. • Deep learning can be used to create an automated bone age assessment model based on pelvic radiographs. • The deep learning convolutional neural network model achieves performance on par with the existing cubic regression model.
Collapse
|
21
|
Mânica S, Wong FSL, Davis G, Liversidge HM. Estimating age using permanent molars and third cervical vertebrae shape with a novel semi-automated method. J Forensic Leg Med 2018; 58:140-144. [PMID: 29966814 DOI: 10.1016/j.jflm.2018.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/10/2018] [Accepted: 05/25/2018] [Indexed: 12/01/2022]
Abstract
Estimating chronological age accurately in young adults is difficult and additional methods are required to increase the accuracy. This study explored a new semi-automated method to assess shape change of third cervical vertebra (C3) with age in the living; comparing this as a method to determine whether individuals could be categorised into being less than 18 years of age (<18), or at least 18 years of age (≥18) with tooth formation of the second and third mandibular molars (M2 and M3). The sample was panoramic and lateral skull radiographs of 174 dental patients (78 males, 96 females aged 15-22 years). Twelve variables were compared in two age categories: younger than 18 and at least 18 years of age in males and females separately using a t-test. Tooth formation of M2 and M3 was assessed. Mean values of eight variables of C3 in males and one variable in females were significantly different between the two age categories (p < 0.05). Results for males showed that the best age indicator for age ≥18 was the ratio between height and width of C3 and for females, the ratio between diagonals. Results for molars showed that M2 was mature in 69% of males and 83% of females, within the expected age range of 14-16 years. M3 was highly variable ranging from stages 6-14 for both; M3 was missing in 24% of males and 28% of females and mature in 14% of males and 15% of females. The conclusion was that shape change of C3 has potential as an additional method to group individuals <18 and ≥ 18 years of age.
Collapse
Affiliation(s)
- Scheila Mânica
- Institute of Dentistry, Queen Mary University of London, UK.
| | | | - Graham Davis
- Institute of Dentistry, Queen Mary University of London, UK
| | | |
Collapse
|
22
|
Choi JA, Kim YC, Min SJ, Khil EK. A simple method for bone age assessment: the capitohamate planimetry. Eur Radiol 2018; 28:2299-2307. [PMID: 29383523 PMCID: PMC5938295 DOI: 10.1007/s00330-017-5255-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/04/2017] [Accepted: 12/18/2017] [Indexed: 11/26/2022]
Abstract
Objectives To determine if the capitohamate (CH) planimetry could be a reliable indicator of bone age, and to compare it with Greulich-Pyle (GP) method. Methods This retrospective study included 391 children (age, 1–180 months). Two reviewers manually measured the areas of the capitate and hamate on plain radiographs. CH planimetry was defined as the measurement of the sum of areas of the capitate and hamate. Two reviewers independently applied the CH planimetry and GP methods in 109 children whose heights were at the 50th percentile of the growth chart. Results There was a strong positive correlation between chronological age and CH planimetry measurement (right, r = 0.9702; left, r = 0.9709). There was no significant difference in accuracy between CH planimetry (84.39–84.46 %) and the GP method (85.15–87.66 %) (p ≥ 0.0867). The interobserver reproducibility of CH planimetry (precision, 4.42 %; 95 % limits of agreement [LOA], −10.5 to 13.4 months) was greater than that of the GP method (precision, 8.45 %; LOA, −29.5 to 21.1 months). Conclusions CH planimetry may be a reliable method for bone age assessment. Key Points • Bone age assessment is important in the work-up of paediatric endocrine disorders. • Radiography of the left hand is widely used to estimate bone age. • Capitatohamate planimetry is a reliable and reproducible method for assessing bone age.
Collapse
Affiliation(s)
- Jung-Ah Choi
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong, 18450, Gyeonggi-do, Republic of Korea
| | - Young Chul Kim
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong, 18450, Gyeonggi-do, Republic of Korea.
| | - Seon Jeong Min
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong, 18450, Gyeonggi-do, Republic of Korea
| | - Eun Kyung Khil
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong, 18450, Gyeonggi-do, Republic of Korea
| |
Collapse
|
23
|
Spampinato C, Palazzo S, Giordano D, Aldinucci M, Leonardi R. Deep learning for automated skeletal bone age assessment in X-ray images. Med Image Anal 2017; 36:41-51. [DOI: 10.1016/j.media.2016.10.010] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 10/10/2016] [Accepted: 10/12/2016] [Indexed: 10/20/2022]
|
24
|
An Automated System for Skeletal Maturity Assessment by Extreme Learning Machines. PLoS One 2015; 10:e0138493. [PMID: 26402795 PMCID: PMC4581666 DOI: 10.1371/journal.pone.0138493] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 08/30/2015] [Indexed: 11/19/2022] Open
Abstract
Assessing skeletal age is a subjective and tedious examination process. Hence, automated assessment methods have been developed to replace manual evaluation in medical applications. In this study, a new fully automated method based on content-based image retrieval and using extreme learning machines (ELM) is designed and adapted to assess skeletal maturity. The main novelty of this approach is it overcomes the segmentation problem as suffered by existing systems. The estimation results of ELM models are compared with those of genetic programming (GP) and artificial neural networks (ANNs) models. The experimental results signify improvement in assessment accuracy over GP and ANN, while generalization capability is possible with the ELM approach. Moreover, the results are indicated that the ELM model developed can be used confidently in further work on formulating novel models of skeletal age assessment strategies. According to the experimental results, the new presented method has the capacity to learn many hundreds of times faster than traditional learning methods and it has sufficient overall performance in many aspects. It has conclusively been found that applying ELM is particularly promising as an alternative method for evaluating skeletal age.
Collapse
|
25
|
Ranabothu S, Kaskel FJ. Validation of automated Greulich-Pyle bone age determination in children with chronic renal failure? Pediatr Nephrol 2015; 30:1051-2. [PMID: 25862023 DOI: 10.1007/s00467-015-3103-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 03/17/2015] [Accepted: 03/18/2015] [Indexed: 11/29/2022]
Abstract
Growth failure is a common problem in children with chronic kidney disease (CKD). The causes are multifactorial and are associated with increased mortality and morbidity. Standard deviations of bone age versus chronological age in children with CKD have not been developed to date. Accurate and early treatment of bone age is an important component of determining the utility of GH therapy. Improvements in bone age assessments are being evaluated to optimize the understanding of growth delay in CKD.
Collapse
Affiliation(s)
- Saritha Ranabothu
- Department of Pediatrics, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA
| | | |
Collapse
|
26
|
A Unified Framework for Brain Segmentation in MR Images. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2015; 2015:829893. [PMID: 26089978 PMCID: PMC4450290 DOI: 10.1155/2015/829893] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/07/2014] [Accepted: 11/18/2014] [Indexed: 12/03/2022]
Abstract
Brain MRI segmentation is an important issue for discovering the brain structure and diagnosis of subtle anatomical changes in different brain diseases. However, due to several artifacts brain tissue segmentation remains a challenging task. The aim of this paper is to improve the automatic segmentation of brain into gray matter, white matter, and cerebrospinal fluid in magnetic resonance images (MRI). We proposed an automatic hybrid image segmentation method that integrates the modified statistical expectation-maximization (EM) method and the spatial information combined with support vector machine (SVM). The combined method has more accurate results than what can be achieved with its individual techniques that is demonstrated through experiments on both real data and simulated images. Experiments are carried out on both synthetic and real MRI. The results of proposed technique are evaluated against manual segmentation results and other methods based on real T1-weighted scans from Internet Brain Segmentation Repository (IBSR) and simulated images from BrainWeb. The Kappa index is calculated to assess the performance of the proposed framework relative to the ground truth and expert segmentations. The results demonstrate that the proposed combined method has satisfactory results on both simulated MRI and real brain datasets.
Collapse
|